Background: Many concerns about liver transplantation in alcoholic patients are related to the risk
of alcohol recidivism. Starting from 2002, an Alcohol Addiction Unit (AAU) was formed within the
liver transplant center for the management of alcoholic patients affected by end-stage liver disease and
included in the waiting list for transplantation. We evaluated retrospectively the impact of the AAU on
alcohol recidivism after transplantation. The relationship between alcohol recidivism and the duration
of alcohol abstinence before transplant was evaluated as well.
Methods: Between 1995 and 2010, 92 cirrhotic alcoholic patients underwent liver transplantation.
Clinical evaluation and management of alcohol use in these patients was provided by psychiatrists with
expertise in addiction medicine not affiliated to the liver transplant center before 2002 (n = 37; group
A), or by the clinical staff of the AAU within the liver transplant center starting from 2002 (n = 55;
Results: Group B, as compared with group A, showed a significantly lower prevalence of alcohol
recidivism (16.4 vs. 35.1%; p = 0.038) and a significantly lower mortality (14.5 vs. 37.8%; p = 0.01).
Furthermore, an analysis of group B patients with either 6 or <6 months of alcohol abstinence before
transplantation showed no difference in the rate of alcohol recidivism (21.1 vs. 15.4%; p = ns).
Conclusions: The presence of an AAU within a liver transplant center reduces the risk of alcohol
recidivism after transplantation. A pretransplant abstinence period <6 months might be considered, at
least in selected patients managed by an AAU.
- Alcohol Addiction Unit
- Alcohol Dependence
- Alcohol Recidivism
- Orthotopic Liver Transplantation